The tolerability and safety of DPP-4 inhibitors for the treatment of older people with type 2 diabetes mellitus: an observational study

Abstract

Aims/introduction:

Despite type 2 diabetes mellitus being up to five times more prevalent in patients aged ≥65 years compared with patients <65 years of age, this population is surprisingly less well studied. Dipeptidyl peptidase (DPP)-4 inhibitor treatment is an option for this older patient group, but clinical practice data for this drug class are sparse in this population. The study examined the efficacy and tolerability of DPP-4 inhibitors in older patients with type 2 diabetes whilst focusing on particular pertinent aspects relevant to care of older persons.

Materials and methods:

The medical records of 431 randomly selected patients (median age 74 years) were reviewed and two cohorts (DPP-4-inhibitor-treated and non-DPP-4-inhibitors-treated) were compared.

Results:

Both groups had a similar duration of diabetes (8 years) and comparable glycated haemoglobin A_1C concentrations (7.4% and 7.2%). Hypoglycaemia was less common in the DPP-4 inhibitor group (3%) compared with the medically treated non-DPP-4 inhibitor group (8%), p<0.02. Despite significantly more patients in the non-DPP-4 inhibitor group living in cared accommodation (9% vs. 2%) this group received significantly more insulin (30% vs. 7%).

Conclusion:

Clinicians need to consider the specific clinical issues relevant to older diabetic patients when taking complex treatment decisions.